The other day, my friend’s mother called her about a medicine she was interested in trying. Her mother has been living with low back pain for the past six months and has been curious about a herbal medicine that her brother swore erased his gout pain. He had gotten the medicine in Indonesia, where they are both currently living. When my best friend asked her what the name of the medicine was, she said it was an old medicine used in Southeast Asian countries and was unsure of the English name. This piqued my interest since I have heard about a Southeast Asian opioid-like medicine gathering both negative and positive interest in the U.S. market recently.
Later on, I found out that the herbal medicine was indeed kratom.
Where Kratom is Legal
Kratom (aka krathom or ketum; Mitragnyna speciosa) is a psychoactive plant in the coffee family and has been used for medicinal purposes for centuries across Southeastern Asia. In these countries, kratom goes by “Thang”, “Kakuam”, “Thom”, “Ketum” and “Biak” in the streets. It is known as a “herbal speedball” in the United Kingdom.
Who Uses Kratom
Kratom, a tropical tree plant, is used to fight against fatigue, improve work productivity and enhance physical endurance by farmers in Southeast Asia. The natives of these countries chop up fresh leaves or dried leaves to make tea or chew and smoke on the leaves themselves. For thousands of years, kratom has been used for socioreligious ceremonies. In addition, kratom is used to treat medical conditions such as weaning off morphine in addicts, diarrhea, and malaria. They also consume kratom for its euphoric and stimulant effect.
Kratom has opioid and psychostimulant-like effects
The alkaloid component of kratom is responsible for the pain-reducing effects of the leaf.
Although the kratom compound acts on similar opioid receptors, it is still structurally different than that of morphine and is theorized to have a broader opioid receptor binding activity.
The main components in the leaves contain structurally alkaloids and 7-hydroxymitragynine. Kratom has a dose-dependent effect where small doses produce stimulant effects similar to those found in cocaine or amphetamines. Larger doses of kratom has sedative-narcotic effects, similar to that of opiates.
Anxiolytic and Anti-inflammatory Effect
Kratom also contains mitragynine, known to produce anxiolytic effects or reduce anxiety. In addition, this component of kratom may have anti-inflammatory properties by suppressing production of prostaglandin E2, a pro-inflammatory in the human body.
More so, kratom may have interactions within the brain on serotonin and adrenergic receptors which could contribute to its antidepressant and mood-changing effects.
Recreational psychoactive drug
Kratom has evolved from a traditional medicine use in Southeast Asian to a recreational psychoactive drug in Western Countries, particularly North America. Kratom was first introduced to the U.S. approximately ten years ago.
In the U.S., Kratom is a blooming market since it remains a legal alternative to controlled substances. The havoc caused by the opioid-crisis in the U.S. created an easier environment for the kratom market to thrive.
New laws, regulations and nationwide shortages have made it harder to obtain a legal prescription for opioids which made people turn elsewhere to get their pain medications.
Can Kratom Kill You?
Around this time, unfounded fears and bias about kratom bloomed. It was a new drug barely studied in the United States. Kratom was confused with bath salts and synthetic cannabis. Sensationalized news with headings such as “Kratom: The supplement that will kill Godzilla” was featured in the media. Studies alluding to the potential serious harm of kratom lacked validity and overrepresented extreme events.
A thorough survey of literature found that many cases of fatality (not all) had involved the use of other substances along with kratom. In addition, these individuals had histories of alcohol dependence or heroin abuse.
Reports of kratom toxicity and mortality were reported in the West but were absent in South East Asia
South East Asia has a long history with kratom. With that being said, there are no reports of toxicity or death due to kratom in South East Asia. This is either due to tolerance build up of kratom or because cases of toxicity go unreported. Another study speculates that the kratom in the West may contain other substances that modifies the drug or that users in the U.S. mix kratom with other illicit drugs such as codeine and Xanax causing kratom poisoning.
Is Kratom Legal?
At the height of this sensationalism, there was a report by the Centers for Disease Control and Prevention (CDC) stating a significant increase in poison control centers kratom-related calls between 2011 and 2015. Of the 660 calls, 7.4% of them were categorized as life-threatening.
On August 2016, the Drug Enforcement Administration (DEA) attempted to place kratom into the schedule I of the controlled substances act. After two months, they later rescinded the attempt due to the public outcry challenging the action and are pending further information on the substance and consequences of its use.
The DEA’s attempt to regulate kratom after baseless and sensationalized claims appears grossly overreached when examining kratom’s apparent risk.
What made the public challenge this action?
The fact that the public was able to win a motion against the DEA deserves a bit of attention.
The internet was angry – the government is yet again, stomping on their playground. They devoted their energy into sending letters, making phone calls to Congress and signing online petitions against the DEA notion. And this time, it was a win for those against the government’s seemingly neverending drug war.
Many people rely on kratom
Many people rely on kratom to improve their quality of life. According to the survey, a significant portion of kratom users took kratom for its analgesic qualities. More specifically, 6466 out of 8049 individuals (85.01%) found that kratom decreased their pain. Easy access to kratom led to the improvement in the quality of life in these individuals.
With the use of kratom, there was a reduction or stop in use of opioid pain-relieving medications.
The results of a large online study found that kratom is primarily used by younger-middle aged middle class Caucasian males with some college education. Self-reported benefits of kratom–use include decreased pain (85.01%), increased energy (83.75%), and less depressive mood (80%).
Online and traditional experiences report that effects of kratom depends on how much you take. At low to moderate dose (1-5grams), kratom has a mild pleasant stimulant effect and at moderate-high dose (5-15grams), it has a analgesia and sedative effect similar to that of morphine.
Overall, self-reported side effects of kratom were most commonly gastrointestinal related including nausea and constipation. Dizziness or drowsiness were reported 4.81% of the time. These negative effects were found to be dose-dependent. When taken at lower doses, kratom has less negative effects.
Kratom withdrawal symptoms are similar in both Western countries and Southeast Asian countries.
Kratom withdrawal symptoms include craving, nausea, fatigue, insomnia, restlessness and anxiety.
These symptoms were found in subjects who used kratom at least three times a week. Kratom withdrawal symptoms are similar to opioid withdrawal but is more mild and shorter in duration.
Kratom for Opioid Withdrawal
Many do not like the thought of replacing a drug with another drug. The long-term consequences of methadone replacement for more dangerous substances like heroin is comparable to putting a bandaid on a gushing wound. However, various studies conducted in Northern Malaysia found that kratom helped reduce or stop addictions to illicit substances like opioids.
Similarly, in the United States, almost half of 8049 kratom-users reported that kratom enabled them to stop or reduce their usage of opioids.
In another study of 161 participants, over 10% had a positive response to kratom and reported a reduction or abstinence in harmful drugs (opioids most commonly reported).
The Opioid-Overdose Crisis In The U.S.
Kratom Does Not Cause Respiratory Depression
Kratom does still have a risk for abuse like that of opioids. Although, the risk is much less than that of opioids. What makes opioids particularly dangerous is its ability to reduce respiratory drive. In layman’s term, you take too much of opioids and you will stop breathing. This is the main cause of fatal overdoses.
Kratom does not have respiratory depression effects like opioids.
Thus, kratom is far less likely to cause fatal overdoses and may be a holy grail for opioid withdrawal.
Kratom, a psychoactive plant, when crushed and ingested orally has analgesic and mood-altering effects. It has been used for centuries by Southeast Asian countries as medicine for treatment of diarrhea, pain, and fever. After it’s introduction into North America, baseless sensationalized claims were made about its potential to cause harm. More so, the DEA attempted to control its use without high-quality evidence to support their action causing a huge public backlash.
Large online studies found that many individuals in the U.S. relied on kratom to reduce pain and even reported improvement in depressive symptoms.
Every day, over 130 people die to fatal opioid overdoses in the U.S.
Perhaps the biggest benefit of kratom is its potential to reduce harm in those addicted to opioids. Kratom appears to have several mental health and analgesic benefits. Most notably kratom has the potential to be used as a harm reduction tool in the opioid-overdose crisis. Government control of kratom could slow down or even stop research and studies on kratom.
In conclusion, Kratom has the potential to be a life-saving drug and warrants new additional studies to evaluate its benefits and risks. It’s imperative to strengthen the understanding of these public health risks and provide support for cutting-edge and update-to-date research on addiction and pain.
What other drugs are being marketed to help with mental health disorders? Learn more about how ketamine could cure depression.
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